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      Association between high cystatin C levels and carotid atherosclerosis

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          Abstract

          AIM

          To investigate the association between carotid atherosclerosis and cystatin C (CysC) and to determine the optimal CysC cut-off value.

          METHODS

          One hundred twenty-eight subjects were included in this study. Atherosclerosis was defined as a maximum carotid plaque thickness (MCPT) of greater than 2 mm. A receiver operating characteristic curve analysis was used to determine the diagnostic value of serum CysC for atherosclerosis. The subjects were divided into two groups according to the CysC cut-off value. We screened for diabetes, hypertension, dyslipidemia, smoking status, alcohol consumption, and exercise behavior. The association between atherosclerosis and CysC levels was assessed using multivariate analysis.

          RESULTS

          The subjects were then divided into two groups according to the CysC cut-off value (0.73 mg/L). The median age of the high CysC group was 72 years (85% males), whereas that of the low CysC group was 61 years (63% males). The CysC levels were significantly correlated with Cr and estimated glomerular filtration rate (eGFR) values. Body-mass index, visceral fat area, hypertension, diabetes mellitus, and MCPT were significantly higher in the high CysC group than in the low CysC group. Furthermore, the eGFR was significantly lower in the high CysC group. Regarding lifestyle habits, only the exercise level was lower in the high CysC group than in the low CysC group. Multivariate analysis, adjusted for age and sex, revealed that high CysC levels were significantly associated with an MCPT of ≥ 2 mm (odds ratio: 2.92; 95%CI: 1.13-7.99).

          CONCLUSION

          Higher CysC levels were associated with an MCPT of ≥ 2 mm. The CysC cut-off value of 0.73 mg/L appears to aid in the diagnosis of atherosclerosis.

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          Most cited references25

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          The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology.

          The environment in which the field of cardiology finds itself has been rapidly changing. This supplement, an expansion of a report created for the Board of Trustees, is intended to provide a timely snapshot of the socio-economic, political, and scientific aspects of this environment as it applies to practice both in the United States and internationally. This publication should assist healthcare professionals looking for the most recent statistics on cardiovascular disease and the risk factors that contribute to it, drug and device trends affecting the industry, and how the practice of cardiology is changing in the United States. Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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            Elevations of inflammatory and procoagulant biomarkers in elderly persons with renal insufficiency.

            Renal insufficiency has been associated with cardiovascular disease events and mortality in several prospective studies, but the mechanisms for the elevated risk are not clear. Little is known about the association of renal insufficiency with inflammatory and procoagulant markers, which are potential mediators for the cardiovascular risk of kidney disease. The cross-sectional association of renal insufficiency with 8 inflammatory and procoagulant factors was evaluated using baseline data from the Cardiovascular Health Study, a population-based cohort study of 5888 subjects aged > or =65 years. C-reactive protein, fibrinogen, factor VIIc, and factor VIIIc levels were measured in nearly all participants; interleukin-6, intercellular adhesion molecule-1, plasmin-antiplasmin complex, and D-dimer levels were measured in nearly half of participants. Renal insufficiency was defined as a serum creatinine level > or =1.3 mg/dL in women and > or =1.5 mg/dL in men. Multivariate linear regression was used to compare adjusted mean levels of each biomarker in persons with and without renal insufficiency after adjustment for other baseline characteristics. Renal insufficiency was present in 647 (11%) of Cardiovascular Health Study participants. After adjustment for baseline differences, levels of C-reactive protein, fibrinogen, interleukin-6, factor VIIc, factor VIIIc, plasmin-antiplasmin complex, and D-dimer were significantly greater among persons with renal insufficiency (P<0.001). In participants with clinical, subclinical, and no cardiovascular disease at baseline, the positive associations of renal insufficiency with these inflammatory and procoagulant markers were similar. Renal insufficiency was independently associated with elevations in inflammatory and procoagulant biomarkers. These pathways may be important mediators leading to the increased cardiovascular risk of persons with kidney disease.
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              The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2009).

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                Author and article information

                Journal
                World J Cardiol
                WJC
                World Journal of Cardiology
                Baishideng Publishing Group Inc
                1949-8462
                26 February 2017
                26 February 2017
                : 9
                : 2
                : 174-181
                Affiliations
                Toshiyuki Kobayashi, Department of General Medicine, Zama General Hospital, Kanagawa 252-0011, Japan
                Toshiyuki Kobayashi, Hirohide Yokokawa, Kazutoshi Fujibayashi, Tomomi Haniu, Teruhiko Hisaoka, Hiroshi Fukuda, Toshio Naito, Department of General Medicine, School of Medicine, Juntendo University, Tokyo 113-8431, Japan
                Author notes

                Author contributions: Kobayashi T, Yokokawa H, Fujibayashi K, Haniu T, Hisaoka T, Fukuda H and Naito T participated in the design of the study; Kobayashi T, Yokokawa H and Fujibayashi K participated in data collection, analysis of the data, and drafting of the manuscript; Kobayashi T, Yokokawa H and Fujibayashi K conceived of the study, participated in its design, and revised the manuscript; Kobayashi T, Yokokawa H and Fujibayashi K participated in analysis of the data and revised the manuscript; all authors read and approved the final manuscript.

                Correspondence to: Toshiyuki Kobayashi, MD, Department of General Medicine, Zama General Hospital, 1-50-1, Sobudai, Zama City, Kanagawa 252-0011, Japan. tykobaya@ 123456juntendo.ac.jp

                Telephone: +81-46-2331311 Fax: +81-46-2328934

                Article
                jWJC.v9.i2.pg174
                10.4330/wjc.v9.i2.174
                5329745
                28289532
                3f8e313b-0733-4b0d-b497-6b82b0a9ff20
                ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.

                Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 6 November 2016
                : 21 December 2016
                : 11 January 2017
                Categories
                Observational Study

                cystatin c,atherosclerosis,carotid plaque,maximum carotid plaque thickness,visceral fat

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